What tests do I need?

Posted by JohnL on June 25, 1999, at 21:24:24

OK. I'm going back to square one. Next week I will see my doctor and request a full work-up for physical causes of depression. It's been 5 years since a bloodtest. I don't want to miss anything. What should I ask about? Thyroid, upper 1/4 of normal range, understand that. Cortisol? Ummm, what else? DHEA? Testosterone? I'm sure my doc will know, but I would like to know what you all think is important to check for.

Background: Dysthymic since childhood. First major depression with psychotic features diagnosed in 1995. Labelled bipolar, though any possible hypomanic episodes were short, mild, and questionable at best. Always outpatient, able to function. Was OK on Paxil for a year. But impotence and bad sleep and a seemingly total recovery caused me to quit. Depression returned in 3 months, slow but sure. Since then, lots of counseling, Zoloft, Prozac, Serzone, Effexor, Wellbutrin, Pamelor, Remeron, Vivactil, Moclobemide, St. Johnswort, 5HTP, SAMe, and various combinations. Four problems: 1)Not effective at appropriate dose, 2) Disabling sexual side effects, 3)Terribly loud ringing in the ear, 4)Depression actually worsened by antidepressant. With all my sensitivities and atypical reactions to drugs, I can't help but think maybe there's something I overlooked. Thus the thought to get back to basics. Most recently went on Paxil again, hoping to augment with Naltrexone, but after just one week I was reminded of all the reasons I quit Paxil years ago that I forgot about...my hair falls out badly, I sleep badly even when I sleep all night, and of course that sex thing.

If tests come out OK, I will discuss Buspar+Pindolol(saw a NYU study showing this combo to work great and fast, especially on symtpoms of apathy/anhedonia, MY symptoms!); or a stimulant; or maybe a second stab at Serzone; or, hey, I remember a doctor once saying Anafranil was great for sex. Was he being sarcastic, or it that true? And I still have a bottle of Naltrexone to try with whatever.

Questions: 1. What tests should I ask for? 2. Anyone know if Anafranil (Clomipramine) is good for sex? Or was the doc joking. 3. Any other input?